By Lisa Rapaport
(Reuters Health) – Looking online for alternative medicine providers to diagnose or treat celiac disease is a bad idea because many websites market unproven or ineffective tests and treatments, researchers say.
“We know that complementary and alternative medicine is widespread, and people seek out acupuncture, homeopathy and naturopathy for a variety of reasons, and we also know that avoidance of gluten and the popularity of the gluten-free diet has exploded in recent years, far out of proportion to the prevalence of celiac disease,” said senior study author Dr. Benjamin Lebwohl, director of clinical research at the Celiac Disease Center at Columbia University in New York City.
“We wanted to know if these two phenomena were linked,” Lebwohl said by email.
To find out, researchers looked at marking claims on websites for 500 alternative medicine providers like chiropractors, naturopaths and acupuncturists in the 10 most populous U.S. cities.
Overall, 178 sites, or 36 percent, made at least one claim regarding celiac disease, gluten sensitivity or a gluten-free diet. And 60 percent of these marketing claims were either false or unproven, the study found.
“This is of concern, given the popularity of complementary and alternative medicine (CAM) and the fact that misinformation on this topic can lead to misdiagnosis of celiac disease, unnecessarily restrictive (and possibly unhealthy) diets, and delays in diagnosis of other conditions that may be underlying the patient’s symptoms,” Lebwohl said.
Roughly 1 percent of people have celiac disease, an autoimmune disorder that damages the small intestine if gluten is consumed, researchers note in the American Journal of Gastroenterology. Gluten is a protein found in wheat, barley and rye.
Celiac disease has become more common in recent years, due in part to increased awareness and testing, but also because intolerance to gluten is becoming more common in the population, they add.
The condition can be detected with a blood test for antibodies that show an immune response to gluten in the gastrointestinal tract, and may also be confirmed by a biopsy of the small intestine. When celiac is diagnosed, patients are advised to go on a gluten-free diet to ease symptoms such as abdominal pain, bloating, gas, diarrhea, anemia and weight loss.
In the study, 40 percent of naturopath clinics advertised at least one option for diagnosing or treating celiac disease. So did 36 percent of integrative medicine clinics, 20 percent of homeopaths, 14 percent of acupuncturists and 12 percent of chiropractors.
For gluten sensitivity, 45 percent of integrative medicine clinics advertised at least one diagnosis or treatment, followed by 37 percent of naturopaths, 14 percent of homeopaths and chiropractors and 10 percent of acupuncturists.
The study wasn’t designed to assess health outcomes for anyone who tried the marketed services.
But there are many potential harms, including the potential for patients to throw a lot of money away on tests and treatments with no track record of success, said Dr. Joseph Murray, a researcher with the Celiac Disease Program at the Mayo Clinic in Rochester, Minnesota.
There’s also the risk that patients will be misdiagnosed, or get sicker while a proper diagnosis is delayed, Murray, who wasn’t involved in the study, said by email.
“It is well known and often seen that patients who have celiac disease are more difficult to diagnose properly if they have been started on a gluten-free diet without sufficient testing first,” Murray said.
SOURCE: https://bit.ly/2UV2YpY American Journal of Gastroenterology, online April 24, 2019.